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Clinical Course of acute-on-chronic liver failure syndrome and effects on prognosis

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F15%3A00059742" target="_blank" >RIV/00023001:_____/15:00059742 - isvavai.cz</a>

  • Result on the web

    <a href="http://onlinelibrary.wiley.com/doi/10.1002/hep.27849/abstract;jsessionid=E2E3CAE8C6F9EB2B1C1B1B9AEAC5EC84.f03t01" target="_blank" >http://onlinelibrary.wiley.com/doi/10.1002/hep.27849/abstract;jsessionid=E2E3CAE8C6F9EB2B1C1B1B9AEAC5EC84.f03t01</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.1002/hep.27849" target="_blank" >10.1002/hep.27849</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Clinical Course of acute-on-chronic liver failure syndrome and effects on prognosis

  • Original language description

    Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation (AD) of cirrhosis, organ failure(s), and high 28-day mortality. We investigated whether assessments of patients at specific time points predicted their need for liver transplantation (LT) or the potential futility of their care. We assessed clinical courses of 388 patients who had ACLF at enrollment, from February through September 2011, or during early (28-day) follow-up of the prospective multicenter European Chronic Liver Failure (CLIF) ACLF in Cirrhosis study. We assessed ACLF grades at different time points to define disease resolution, improvement, worsening, or steady or fluctuating course. ACLF resolved or improved in 49.2%, had a steady or fluctuating course in 30.4%, and worsened in 20.4%. The 28-day transplant-free mortality was low-to-moderate (6%-18%) in patients with nonsevere early course (final no ACLF or ACLF-1) and high-to-very high (42%-92%) in those with severe early course (final ACLF-2 or -3) independently of initial grades. Independent predictors of course severity were CLIF Consortium ACLF score (CLIF-C ACLFs) and presence of liver failure (total bilirubin GREATER-THAN OR EQUAL TO12 mg/dL) at ACLF diagnosis. Eighty-one percent had their final ACLF grade at 1 week, resulting in accurate prediction of short- (28-day) and mid-term (90-day) mortality by ACLF grade at 3-7 days. Among patients that underwent early LT, 75% survived for at least 1 year. Among patients with GREATER-THAN OR EQUAL TO4 organ failures, or CLIF-C ACLFs >64 at days 3-7 days, and did not undergo LT, mortality was 100% by 28 days.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>x</sub> - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)

  • CEP classification

    FE - Other fields of internal medicine

  • OECD FORD branch

Result continuities

  • Project

  • Continuities

    N - Vyzkumna aktivita podporovana z neverejnych zdroju

Others

  • Publication year

    2015

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Hepatology

  • ISSN

    0270-9139

  • e-ISSN

  • Volume of the periodical

    62

  • Issue of the periodical within the volume

    1

  • Country of publishing house

    US - UNITED STATES

  • Number of pages

    10

  • Pages from-to

    243-252

  • UT code for WoS article

    000356864800030

  • EID of the result in the Scopus database